What Is CBD?
CBD is an abbreviation for Cannabidiol, a chemical compound found naturally in the cannabis plant. Over the past 40 years, there have been numerous studies that highlight the potential benefits of CBD and how it can support the Endocannabinoid System (ECS), the network of receptors in every person
WILL CBD MAKE ME “HIGH”?
Cannabidiol (CBD) hemp oil is made from the hemp plant which is high in CBD and low in THC, unlike medical marijuana products that come from the female cannabis plant. Containing only trace amounts of THC, the extracted CBD oil will not cause the psychoactive effects similar to those of tetrahydrocannabinol (THC), present in marijuana. Cannabidiol is just one of over 85 cannabinoids presently identified in the cannabis plant and is the second most abundant cannabinoid in marijuana after THC. CBD is naturally occurring in the human body (through our Endocannabinoid Systems), so it interacts with our naturally occurring systems, but is non-psychotropic. This makes it a safer, less controversial alternative, while still offering significant health benefits.
HOW DOES CBD WORK IN THE BODY?
CBD or cannabidiol is the main active compound in hemp and unlike THC, it is not psychoactive, so it doesn’t make you high. As you may know, inside the human body there’s the endocannabinoid system, with receptors spread throughout the brain and body. THC activates the CB1 and CB2 receptors, while CBD does not directly stimulate these receptors.
Cannabinoid receptors are involved in a series of processes inside the human body, including the regulation of mood, pain sensation, appetite and memory.
These receptors can be activated by endocannabinoids (produced by the human body) as well as by plant cannabinoids (like those found in hemp or cannabis), and they’re grouped in two main categories: CB1 and CB2.
CB1 receptors are found mostly in the central nervous system, and in smaller numbers in the liver, kidneys and lungs, while CB2 receptors are part of the immune system and found in the hematopoietic blood cells as well. CB1 play a role in the production and release of neurotransmitters, cannabis products that exert psychoactive effects stimulating these receptors.
At the same time, CB1 receptors are involved in the lipogenesis process that takes place inside the liver, and seem to play a role in the maintenance of homeostasis (body’s internal equilibrium). Various studies suggest that CB1 also influence pleasure, concentration and appetite, memory and pain.
HOW MUCH CBD OIL SHOULD YOU TAKE?The dosage amount of CBD per individual and per treatment condition will vary. We recommend starting with a dose of 5-10mg twice per day, and increasing from there based on desired effects.
CAN YOU TAKE TOO MUCH CBD OIL?
CBD has no known adverse side effects, but an excessive amount of CBD could be less effective therapeutically than a moderate dose.
HOW LONG DOES IT TAKE FOR CBD TO TAKE EFFECT?
Taking CBD orally takes longer (20-30 mins) to absorb than other methods like vaping which is almost instant. When eating CBD products, some of this hydrophobic (non-water soluble) organic compound tends to diffuse out of the blood and into the fatty tissues. CBD also needs to pass through the gut and liver which also reduce it’s bioavailability in the body. Vaping CBD allows for rapid and more abundant absorption into the blood stream via the lungs, however vaping is not for everyone. Liposomes are also a good option if you are looking for an alternative with better bioavailability than typical oral consumption.
CAN YOU PUT CBD OIL ON YOUR TONGUE?
For maximum absorption, the best way to take CBD oil orally is to consume it by putting it under your tongue and avoid swallowing for at least 30 seconds.
CAN YOU USE CBD OIL IN A VAPE?
Yes. Vaping CBD has proved to be a better absorption and more rapid delivery method than oral consumption. Be sure you are puchasing your vape products from a reliable source and know what you are ingesting.
WHAT ARE THE SIDE EFFECTS OF CBD?
There are no serious side effects known, however, the following have been reported:
High concentrations of CBD have been shown to activate the 5-HT1A serotonin receptor, exerting anti-depressant effects. The same receptor is involved in a series of processes from pain perception, appetite, nausea and anxiety to sleep and addiction mechanisms. Talk to a doctor to find out if CBD is right for you.
CAN CBD HELP WITH ANXIETY AND MOOD?
Most people have heard of THC or Tetrahydrocannabinol – the one that gets you high – although for many people THC can actually bring on feelings of paranoia and anxiety. However CBD is considered non-psychoactive and an increasing number of studies point towards its anti-inflammatory, neuroprotective and anti-anxiety properties. Cannabis has been used for centuries to treat nerves and anxiety, as well as other mood problems. CBD may help to improve both depression and anxiety, at least in part through its interactions with serotonin receptors in the brain. Research shows that CBD can reduce both mental and physical symptoms of anxiety. So far, most research hasn’t made it beyond the science lab, with very few human trials taking place. However, in the case of CBD and its anxiolytic (anti-anxiety) effects, a number of trials on real, live people have been documented showing that taking CBD does in fact reduce feelings of anxiety. A study of CBD given to people before a public-speaking event indicates that CBD can help reduce stress—this and other research has shown that CBD can be an effective treatment for social anxiety.
CAN CBD HELP WITH SLEEP DISORDERS?
CBD has the ability to reduce anxiety, which can be helpful in reducing sleep difficulties and improving sleep quality. CBD may increase overall sleep amounts, and improve insomnia, according to research. CBD has been shown to reduce insomnia in people who suffer from chronic pain.
In smaller doses, CBD stimulates alertness and reduces daytime sleepiness, which is important for daytime performance and for the strength and consistency of the sleep-wake cycle.
CAN HEMP OIL BE USED FOR PAIN AND INFLAMMATION?
The activation of adenosine receptors by CBD gives the anti-anxiety and anti-inflammatory effects of cannabidiol. Adenosine receptors are also involved in the release of dopamine and glutamate, two neurotransmitters that play major roles inside the body. Dopamine is involved in cognition, motor control, motivation and reward mechanisms, while glutamate is one of the major mediators of excitatory signals, being involved in memory, learning and cognition.
Cannabidiol (CBD) oil is used by some people with chronic pain from certain illnesses and medical conditions. Researchers think that CBD interacts with receptors in your brain and immune system. Receptors are tiny proteins attached to your cells that receive chemical signals from different stimuli and help your cells respond. This creates anti-inflammatory and painkilling effects that help with pain management. This means that CBD oil may benefit people with chronic pain, such as chronic back pain.
CAN CBD HELP WITH ALCOHOLISM AND ADDICTION?
When CBD is taken into the system, CB1 receptors receive a large amount of CBD, resulting in a feeling of satisfaction or “having been rewarded”.
CBD receptors are located in the brain, abdomen and reproductive area.
The brain is most affected by alcohol, so it is very important to take a sufficient amount of CBD to combat the alcoholism.
When you take CBD it will stop the craving for alcohol and suppress the negative effects of alcoholism. Therefore, when an alcohol-dependent person attempts to reduce or eliminate their alcohol consumption, treatments to increase the signals of cannabinoid receptors in the brain may prove to be useful, my statement to be motivated as follows:
No. However, consuming unusually large dosages of CBD, such as 1,000 to 2,000 milligrams per day, could theoretically trigger a positive for THC on a urine test through trace amounts found with CBD — but that would be a false positive.
CBD is an abbreviation for Cannabidiol, a chemical compound found naturally in the cannabis plant. Over the past 40 years, there have been numerous studies that highlight the potential benefits of CBD and how it can support the Endocannabinoid System (ECS), the network of receptors in every person
WILL CBD MAKE ME “HIGH”?
Cannabidiol (CBD) hemp oil is made from the hemp plant which is high in CBD and low in THC, unlike medical marijuana products that come from the female cannabis plant. Containing only trace amounts of THC, the extracted CBD oil will not cause the psychoactive effects similar to those of tetrahydrocannabinol (THC), present in marijuana. Cannabidiol is just one of over 85 cannabinoids presently identified in the cannabis plant and is the second most abundant cannabinoid in marijuana after THC. CBD is naturally occurring in the human body (through our Endocannabinoid Systems), so it interacts with our naturally occurring systems, but is non-psychotropic. This makes it a safer, less controversial alternative, while still offering significant health benefits.
HOW DOES CBD WORK IN THE BODY?
CBD or cannabidiol is the main active compound in hemp and unlike THC, it is not psychoactive, so it doesn’t make you high. As you may know, inside the human body there’s the endocannabinoid system, with receptors spread throughout the brain and body. THC activates the CB1 and CB2 receptors, while CBD does not directly stimulate these receptors.
Cannabinoid receptors are involved in a series of processes inside the human body, including the regulation of mood, pain sensation, appetite and memory.
These receptors can be activated by endocannabinoids (produced by the human body) as well as by plant cannabinoids (like those found in hemp or cannabis), and they’re grouped in two main categories: CB1 and CB2.
CB1 receptors are found mostly in the central nervous system, and in smaller numbers in the liver, kidneys and lungs, while CB2 receptors are part of the immune system and found in the hematopoietic blood cells as well. CB1 play a role in the production and release of neurotransmitters, cannabis products that exert psychoactive effects stimulating these receptors.
At the same time, CB1 receptors are involved in the lipogenesis process that takes place inside the liver, and seem to play a role in the maintenance of homeostasis (body’s internal equilibrium). Various studies suggest that CB1 also influence pleasure, concentration and appetite, memory and pain.
HOW MUCH CBD OIL SHOULD YOU TAKE?The dosage amount of CBD per individual and per treatment condition will vary. We recommend starting with a dose of 5-10mg twice per day, and increasing from there based on desired effects.
CAN YOU TAKE TOO MUCH CBD OIL?
CBD has no known adverse side effects, but an excessive amount of CBD could be less effective therapeutically than a moderate dose.
HOW LONG DOES IT TAKE FOR CBD TO TAKE EFFECT?
Taking CBD orally takes longer (20-30 mins) to absorb than other methods like vaping which is almost instant. When eating CBD products, some of this hydrophobic (non-water soluble) organic compound tends to diffuse out of the blood and into the fatty tissues. CBD also needs to pass through the gut and liver which also reduce it’s bioavailability in the body. Vaping CBD allows for rapid and more abundant absorption into the blood stream via the lungs, however vaping is not for everyone. Liposomes are also a good option if you are looking for an alternative with better bioavailability than typical oral consumption.
CAN YOU PUT CBD OIL ON YOUR TONGUE?
For maximum absorption, the best way to take CBD oil orally is to consume it by putting it under your tongue and avoid swallowing for at least 30 seconds.
CAN YOU USE CBD OIL IN A VAPE?
Yes. Vaping CBD has proved to be a better absorption and more rapid delivery method than oral consumption. Be sure you are puchasing your vape products from a reliable source and know what you are ingesting.
WHAT ARE THE SIDE EFFECTS OF CBD?
There are no serious side effects known, however, the following have been reported:
- Lightheadedness.
- Dry Mouth
- Drowsiness.
High concentrations of CBD have been shown to activate the 5-HT1A serotonin receptor, exerting anti-depressant effects. The same receptor is involved in a series of processes from pain perception, appetite, nausea and anxiety to sleep and addiction mechanisms. Talk to a doctor to find out if CBD is right for you.
CAN CBD HELP WITH ANXIETY AND MOOD?
Most people have heard of THC or Tetrahydrocannabinol – the one that gets you high – although for many people THC can actually bring on feelings of paranoia and anxiety. However CBD is considered non-psychoactive and an increasing number of studies point towards its anti-inflammatory, neuroprotective and anti-anxiety properties. Cannabis has been used for centuries to treat nerves and anxiety, as well as other mood problems. CBD may help to improve both depression and anxiety, at least in part through its interactions with serotonin receptors in the brain. Research shows that CBD can reduce both mental and physical symptoms of anxiety. So far, most research hasn’t made it beyond the science lab, with very few human trials taking place. However, in the case of CBD and its anxiolytic (anti-anxiety) effects, a number of trials on real, live people have been documented showing that taking CBD does in fact reduce feelings of anxiety. A study of CBD given to people before a public-speaking event indicates that CBD can help reduce stress—this and other research has shown that CBD can be an effective treatment for social anxiety.
CAN CBD HELP WITH SLEEP DISORDERS?
CBD has the ability to reduce anxiety, which can be helpful in reducing sleep difficulties and improving sleep quality. CBD may increase overall sleep amounts, and improve insomnia, according to research. CBD has been shown to reduce insomnia in people who suffer from chronic pain.
In smaller doses, CBD stimulates alertness and reduces daytime sleepiness, which is important for daytime performance and for the strength and consistency of the sleep-wake cycle.
CAN HEMP OIL BE USED FOR PAIN AND INFLAMMATION?
The activation of adenosine receptors by CBD gives the anti-anxiety and anti-inflammatory effects of cannabidiol. Adenosine receptors are also involved in the release of dopamine and glutamate, two neurotransmitters that play major roles inside the body. Dopamine is involved in cognition, motor control, motivation and reward mechanisms, while glutamate is one of the major mediators of excitatory signals, being involved in memory, learning and cognition.
Cannabidiol (CBD) oil is used by some people with chronic pain from certain illnesses and medical conditions. Researchers think that CBD interacts with receptors in your brain and immune system. Receptors are tiny proteins attached to your cells that receive chemical signals from different stimuli and help your cells respond. This creates anti-inflammatory and painkilling effects that help with pain management. This means that CBD oil may benefit people with chronic pain, such as chronic back pain.
CAN CBD HELP WITH ALCOHOLISM AND ADDICTION?
When CBD is taken into the system, CB1 receptors receive a large amount of CBD, resulting in a feeling of satisfaction or “having been rewarded”.
CBD receptors are located in the brain, abdomen and reproductive area.
The brain is most affected by alcohol, so it is very important to take a sufficient amount of CBD to combat the alcoholism.
When you take CBD it will stop the craving for alcohol and suppress the negative effects of alcoholism. Therefore, when an alcohol-dependent person attempts to reduce or eliminate their alcohol consumption, treatments to increase the signals of cannabinoid receptors in the brain may prove to be useful, my statement to be motivated as follows:
- Cannabinoids are likely to act as neuroprotective (nerve protecting) agents having the potential to limit hyper-excitability and therefore preventing brain cell damage. Therefore, Cannabinoid therapy may actively avert the brain damage that would otherwise have been caused by withdrawal;
- Using CBD in conjunction with eliminating alcohol may be useful in treating alcohol dependence and alcohol withdrawal by helping to prevent alcohol cravings.CBD treatment for alcohol is still a new concept, but it does have a lot of potential.
No. However, consuming unusually large dosages of CBD, such as 1,000 to 2,000 milligrams per day, could theoretically trigger a positive for THC on a urine test through trace amounts found with CBD — but that would be a false positive.
What are the Potential Interactions of CBD with Pharmaceutical Drugs?
Pharmaceuticals can interact with one another, as well as with other substances.
Take grapefruit, for instance: a healthy and seemingly harmless food that nonetheless affects a group of liver enzymes in the human body, and thereby alters the way drugs are metabolized. Consuming grapefruit or grapefruit juice can augment the effects, or prolong the presence of, certain drugs in the body — which means that the drugs either may not work as intended or may present more severe side effects. That’s why a significant number of prescription meds carry a warning against consuming grapefruit.
Broadly speaking, CBD is thought to work in the same way. The liver enzymes concerned are in a group called Cytochrome P450 which are known to process drugs and toxins, including those found in about 60 percent of pharmaceutical meds. Because, in simple terms, CBD “occupies” those enzymes for a period of time, the cannabinoid taken orally alongside prescription meds can interfere with the drugs’ effects.
“Unfortunately, the very busy enzymes are the ones that deal with CBD (but not THC), so adding CBD can overload the capacity of those enzymes," Dr. Jordan Tishler, a medical marijuana doctor in Massachusetts, wrote in an email to Civilized. "Oddly this can cause increases or decreases in the medication levels. It’s somewhat unpredictable.”
However, according to Rosalia Yoon, PhD., research scientist at Apollo Cannabis Clinics, most of the information about CBD and drug interactions comes from molecular and animal studies. Others cite case studies to show that CBD has interfered with certain drugs’ actions, but clinical research is somewhat sparse, owing to a few factors: Primarily, federal prohibition has historically made it hard for researchers to get projects approved and funded, and secondly, people metabolize cannabinoids, including CBD, differently — so one person’s adverse dose may be another’s optimal dose.
Which Drugs Are Affected?
According to Dr. Tishler, there are a number of medications that CBD could affect, including benzodiazepines, blood thinners, cardiac medications, seizure drugs, and immunosuppressants used in the case of organ transplants. “Many of these medications need very specific levels," he said, in order to work safely and well.
Blood Thinners: CBD can augment and prolong the effects of warfarin, prescribed as a blood thinner, as well as those of ibuprofen. The risks of over-bleeding grow with the simultaneous use of CBD and these drugs.
Sedatives: Because CBD and THC both carry sedative properties on their own, combining them with sedating benzodiazepines like Xanax, Klonopin, Valium, and Atavan could boost the effects of those drugs in a potentially dangerous way.
Anti-Seizure Meds: CBD is known as an antiepileptic in its own right. However, it must be closely monitored if combined with pharmaceutical anti-seizure meds because it can change the concentrations of the other drugs in the body, rendering the drugs less — not more — effective in preventing seizures.
Chemotherapy Drugs: CBD use alongside chemotherapy treatments can result in higher concentrations of the drugs for longer periods — which isn’t necessarily a good thing. In cancer treatment, the ratios and dosages are highly regulated for optimum effect and minimum toxicity.
However, CBD and THC are both known to alleviate pain from cancer and to slow the growth of cancer cells, so if well monitored, they can both potentially play a role in treatment.
At Which Dosages Does CBD Affect Other Drugs’ Performance?
The extent to which CBD affects the performance of these kinds of drugs is not entirely clear, nor is it evident what concentrations are risky. According to a report by Project CBD, it’s possible that lower doses of the cannabinoid (less than 100 milligrams) would not have much effect. For perspective, a fairly standard dose of CBD is somewhere in the range of 30 milligrams, though people can and do take much larger amounts for therapeutic purposes. Some cite the fact that, because CBD isn’t psychoactive on its own, people sometimes ingest very large servings without knowing.
When Could CBD Interactions Actually Be a Good Thing?
According to Dr. Bill Code, a physician who works with medical marijuana in Canada and author of Solving the Brain Puzzle, CBD can augment the effectiveness of painkillers like OxyContin by four to ten times, which means that pain patients seeking to taper off meds can reduce their dose without dipping into the pain zone. As long as this augmenting action of CBD is known and monitored, the cannabinoid can be instrumental in reducing pharmaceutical dependence.
Dr. Code indicated that if a patient adds a large amount of CBD to an existing painkilling regimen, “that’s a tiny bit risky,” because the CBD slows the breakdown of the narcotic. “So that’s why, when you’re doing this reduction of the narcotic, it’s better to have some THC in there, too,” he said. In fact, for pain relief — including the use of cannabis in conjunction with opioids — Dr. Code will often recommend a 4:1 ratio of THC to CBD because the THC will not interfere with the liver’s processes the way cannabidiol does.
How Dangerous Is It?
It depends on whom you ask.
Yoon emphasized how limited the data currently is on CBD-drug interactions, but also cited a 2016 study by Ethan Russo, which found CBD to be, “safe and well tolerated in humans, even in complex drug regimens with opioids, tricyclic antidepressants, and anticonvulsants.” However, she said, because potential harm is present, it’s vital to work with a knowledgeable practitioner when seeking to combine certain classes of meds and CBD. The risk is particularly strong, she said, for the elderly, and for those with compromised liver or kidney function.
Dr. Tishler advises that patients taking the aforementioned drugs avoid products high in CBD. However, he added, trace amounts found in flower or many vape products are not likely to cause harm.
According to the report from Project CBD, the risks are on part with “mis-dosing the other drug(s) that a patient is taking.” The dangers likely increase with higher doses of CBD (particularly isolates, as opposed to full-spectrum compounds) taken in combination with a pharmaceutical “that has a very narrow window between its therapeutic and toxic levels.”
A patient's metabolism may also play a role: The slower one's metabolism, the longer the effects of the cannabinoid (or another drug) will last in the body, which could influence a patient's level of risk when taking multiple substances at once.
Do the Types of CBD and Modes of Consumption Matter?
Yes. Whole-plant CBD extracts in this case are safer because, with the entourage effect attributed to the mix of THC, CBD, and other plant compounds, a patient may need fewer milligrams of the product to achieve the desired effect. It’s perhaps counterintuitive that products containing some THC may actually be safer than CBD isolates and single-molecule CBD extracts for those taking prescription meds—but, according to experts on the subject, it’s because THC does not have the same effect on the liver enzymes that CBD does.
Inhaling cannabis also poses less risk for drug interactions than orally consuming it because of differences in the liver’s metabolizing process for the two routes. Timing may also matter. Though research on this subject is still in its infancy, there’s some evidence to suggest that consuming CBD several hours after taking a pharmaceutical may reduce its potential interactions.
Pharmaceuticals can interact with one another, as well as with other substances.
Take grapefruit, for instance: a healthy and seemingly harmless food that nonetheless affects a group of liver enzymes in the human body, and thereby alters the way drugs are metabolized. Consuming grapefruit or grapefruit juice can augment the effects, or prolong the presence of, certain drugs in the body — which means that the drugs either may not work as intended or may present more severe side effects. That’s why a significant number of prescription meds carry a warning against consuming grapefruit.
Broadly speaking, CBD is thought to work in the same way. The liver enzymes concerned are in a group called Cytochrome P450 which are known to process drugs and toxins, including those found in about 60 percent of pharmaceutical meds. Because, in simple terms, CBD “occupies” those enzymes for a period of time, the cannabinoid taken orally alongside prescription meds can interfere with the drugs’ effects.
“Unfortunately, the very busy enzymes are the ones that deal with CBD (but not THC), so adding CBD can overload the capacity of those enzymes," Dr. Jordan Tishler, a medical marijuana doctor in Massachusetts, wrote in an email to Civilized. "Oddly this can cause increases or decreases in the medication levels. It’s somewhat unpredictable.”
However, according to Rosalia Yoon, PhD., research scientist at Apollo Cannabis Clinics, most of the information about CBD and drug interactions comes from molecular and animal studies. Others cite case studies to show that CBD has interfered with certain drugs’ actions, but clinical research is somewhat sparse, owing to a few factors: Primarily, federal prohibition has historically made it hard for researchers to get projects approved and funded, and secondly, people metabolize cannabinoids, including CBD, differently — so one person’s adverse dose may be another’s optimal dose.
Which Drugs Are Affected?
According to Dr. Tishler, there are a number of medications that CBD could affect, including benzodiazepines, blood thinners, cardiac medications, seizure drugs, and immunosuppressants used in the case of organ transplants. “Many of these medications need very specific levels," he said, in order to work safely and well.
Blood Thinners: CBD can augment and prolong the effects of warfarin, prescribed as a blood thinner, as well as those of ibuprofen. The risks of over-bleeding grow with the simultaneous use of CBD and these drugs.
Sedatives: Because CBD and THC both carry sedative properties on their own, combining them with sedating benzodiazepines like Xanax, Klonopin, Valium, and Atavan could boost the effects of those drugs in a potentially dangerous way.
Anti-Seizure Meds: CBD is known as an antiepileptic in its own right. However, it must be closely monitored if combined with pharmaceutical anti-seizure meds because it can change the concentrations of the other drugs in the body, rendering the drugs less — not more — effective in preventing seizures.
Chemotherapy Drugs: CBD use alongside chemotherapy treatments can result in higher concentrations of the drugs for longer periods — which isn’t necessarily a good thing. In cancer treatment, the ratios and dosages are highly regulated for optimum effect and minimum toxicity.
However, CBD and THC are both known to alleviate pain from cancer and to slow the growth of cancer cells, so if well monitored, they can both potentially play a role in treatment.
At Which Dosages Does CBD Affect Other Drugs’ Performance?
The extent to which CBD affects the performance of these kinds of drugs is not entirely clear, nor is it evident what concentrations are risky. According to a report by Project CBD, it’s possible that lower doses of the cannabinoid (less than 100 milligrams) would not have much effect. For perspective, a fairly standard dose of CBD is somewhere in the range of 30 milligrams, though people can and do take much larger amounts for therapeutic purposes. Some cite the fact that, because CBD isn’t psychoactive on its own, people sometimes ingest very large servings without knowing.
When Could CBD Interactions Actually Be a Good Thing?
According to Dr. Bill Code, a physician who works with medical marijuana in Canada and author of Solving the Brain Puzzle, CBD can augment the effectiveness of painkillers like OxyContin by four to ten times, which means that pain patients seeking to taper off meds can reduce their dose without dipping into the pain zone. As long as this augmenting action of CBD is known and monitored, the cannabinoid can be instrumental in reducing pharmaceutical dependence.
Dr. Code indicated that if a patient adds a large amount of CBD to an existing painkilling regimen, “that’s a tiny bit risky,” because the CBD slows the breakdown of the narcotic. “So that’s why, when you’re doing this reduction of the narcotic, it’s better to have some THC in there, too,” he said. In fact, for pain relief — including the use of cannabis in conjunction with opioids — Dr. Code will often recommend a 4:1 ratio of THC to CBD because the THC will not interfere with the liver’s processes the way cannabidiol does.
How Dangerous Is It?
It depends on whom you ask.
Yoon emphasized how limited the data currently is on CBD-drug interactions, but also cited a 2016 study by Ethan Russo, which found CBD to be, “safe and well tolerated in humans, even in complex drug regimens with opioids, tricyclic antidepressants, and anticonvulsants.” However, she said, because potential harm is present, it’s vital to work with a knowledgeable practitioner when seeking to combine certain classes of meds and CBD. The risk is particularly strong, she said, for the elderly, and for those with compromised liver or kidney function.
Dr. Tishler advises that patients taking the aforementioned drugs avoid products high in CBD. However, he added, trace amounts found in flower or many vape products are not likely to cause harm.
According to the report from Project CBD, the risks are on part with “mis-dosing the other drug(s) that a patient is taking.” The dangers likely increase with higher doses of CBD (particularly isolates, as opposed to full-spectrum compounds) taken in combination with a pharmaceutical “that has a very narrow window between its therapeutic and toxic levels.”
A patient's metabolism may also play a role: The slower one's metabolism, the longer the effects of the cannabinoid (or another drug) will last in the body, which could influence a patient's level of risk when taking multiple substances at once.
Do the Types of CBD and Modes of Consumption Matter?
Yes. Whole-plant CBD extracts in this case are safer because, with the entourage effect attributed to the mix of THC, CBD, and other plant compounds, a patient may need fewer milligrams of the product to achieve the desired effect. It’s perhaps counterintuitive that products containing some THC may actually be safer than CBD isolates and single-molecule CBD extracts for those taking prescription meds—but, according to experts on the subject, it’s because THC does not have the same effect on the liver enzymes that CBD does.
Inhaling cannabis also poses less risk for drug interactions than orally consuming it because of differences in the liver’s metabolizing process for the two routes. Timing may also matter. Though research on this subject is still in its infancy, there’s some evidence to suggest that consuming CBD several hours after taking a pharmaceutical may reduce its potential interactions.
Is CBD Legal?
The 2018 Farm Bill officially classified hemp with less than 0.3% THC as an approved agricultural crop and removed hemp-derived products with less than 0.3% THC from the government’s Schedule 1 status. So at the federal level, hemp-derived CBD is legal, as are all Green Roads products. That said, each state has the right to create its own laws and regulations, so it’s best to research the specific laws of any state in which you intend to buy or sell CBD.
The 2018 Farm Bill officially classified hemp with less than 0.3% THC as an approved agricultural crop and removed hemp-derived products with less than 0.3% THC from the government’s Schedule 1 status. So at the federal level, hemp-derived CBD is legal, as are all Green Roads products. That said, each state has the right to create its own laws and regulations, so it’s best to research the specific laws of any state in which you intend to buy or sell CBD.